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Drug Interactions between rucaparib and tipiracil / trifluridine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tipiracil rucaparib

Applies to: tipiracil / trifluridine and rucaparib

MONITOR: Coadministration with rucaparib may increase the plasma concentrations and the risk of adverse effects of drugs that are substrates of Multidrug and Toxin Extrusion (MATE) 1, MATE 2-K, organic cation transporter (OCT) 1, and/or OCT 2. The proposed mechanism, based on in vitro data, is decreased clearance due to rucaparib-mediated inhibition of these transport proteins. Rucaparib appears to be a potent inhibitor of MATE 1 and MATE2-K, a moderate inhibitor of OCT1, and a weak inhibitor of OCT2.

MANAGEMENT: Caution is advised if rucaparib is used concomitantly with drugs that are substrates of MATE 1, MATE 2-K, OCT 1 and/or OCT 2, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever rucaparib is added to or withdrawn from therapy with these drugs. Patients should be monitored for the development of adverse effects.

References (1)
  1. EMA. European Medicines Agency. European Union (2013) EMA - List of medicines under additional monitoring. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852

Drug and food interactions

Moderate

trifluridine food

Applies to: tipiracil / trifluridine

ADJUST DOSING INTERVAL: Administration of trifluridine-tipiracil with a standardized high-fat, high-calorie meal has been shown to decrease trifluridine peak plasma concentration (Cmax) as well as tipiracil Cmax and systemic exposure (AUC) by approximately 40% compared to administration in a fasting state in patients with cancer given a single 35 mg/m2 dose. No change in trifluridine AUC was observed.

MANAGEMENT: Based on the observed correlation between increases in the Cmax of trifluridine and decreases in neutrophil counts, trifluridine-tipiracil should be taken within one hour after completion of the morning and evening meals.

References (1)
  1. (2015) "Product Information. Lonsurf (tipiracil-trifluridine)." Taiho Oncology, Inc.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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